A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis

IF 0.1 Q4 EMERGENCY MEDICINE
Buket BADDAL, Aysegul BOSTANCI, Tutku AKSOY, Yasemin KUCUKCİLOGLU, Kaya SÜER
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Abstract

Herpes simplex viruses (HSVs) belong to the Herpesviridae family. Close contact is the primary mode of transmission for both HSV-1 and HSV-2, leading to a persistent lifelong infection. HSVs are widely recognized as causative agents of viral infections affecting the central nervous system, capable of presenting as both meningitis and encephalitis. Herpes simplex virus type 1 (HSV-1) is the predominant viral cause of encephalitis, accounting for the majority of cases. Here, a rare co-infection case of meningoencephalitis, associated with HSV-1 and rickettsia is described. A 42-year-old man presenting with non-remitting headache for 6 days, fever, sweating, and muscle aches was admitted to the Emergency Department. His Weil-Felix test was positive for Proteus OX2 indicating rickettsial infection. Therapy started promptly however patient’s condition deteriorated. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, and elevated protein concentration. CSF molecular analysis was positive for HSV-1. His cranial MRI indicated cytotoxic edema and gyral enhancement at the right temporal lobe. He was administered acyclovir for 14 days during hospital stay and was successfully discharged. This case report highlights that HSV-1 meningoencephalitis can co-occur with rickettsia infection in immunocompetent individuals, and co-infection with other agents should always be considered to avoid the progression of the disease.
一例罕见的男性脑膜脑炎患者立克次体与单纯疱疹病毒1型合并感染
单纯疱疹病毒(hsv)属于疱疹病毒科。密切接触是1型单纯疱疹病毒和2型单纯疱疹病毒的主要传播方式,可导致持续性终身感染。单纯疱疹病毒被广泛认为是影响中枢神经系统的病毒感染的病原体,能够表现为脑膜炎和脑炎。1型单纯疱疹病毒(HSV-1)是脑炎的主要病毒病因,占大多数病例。这里,一个罕见的脑膜脑炎合并感染的情况下,与单纯疱疹病毒-1和立克次体描述。一名42岁男性,因头痛不缓解6天,发热,出汗和肌肉疼痛被送入急诊科。他的Weil-Felix试验呈变形杆菌OX2阳性,表明立克次体感染。治疗迅速开始,但病人的病情恶化。脑脊液(CSF)分析显示淋巴细胞增多,蛋白浓度升高。脑脊液分子分析呈HSV-1阳性。颅脑MRI显示右侧颞叶细胞毒性水肿和脑回增强。他在住院期间给予阿昔洛韦14天,并成功出院。本病例报告强调,1型单纯疱疹病毒脑膜脑炎可在免疫功能正常的个体中与立克次体感染合并发生,应始终考虑与其他病原体合并感染,以避免疾病的进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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